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Laparoscopic or open appendicectomy for suspected appendicitis in pregnancy and evaluation of foetal outcome in Australia

Winter, NN, Guest, Glenn, Bozin, M, Thomson, BN, Mann, GB, Tan, SBM, Clark, DA, Daruwalla, J, Muralidharan, V, Najan, N, Pitcher, ME, Vilhelm, K, Cox, MR, Lane, Stephen and Watters, David 2016, Laparoscopic or open appendicectomy for suspected appendicitis in pregnancy and evaluation of foetal outcome in Australia, ANZ journal of surgery, vol. 87, pp. 1-5, doi: 10.1111/ans.13750.

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Title Laparoscopic or open appendicectomy for suspected appendicitis in pregnancy and evaluation of foetal outcome in Australia
Author(s) Winter, NN
Guest, Glenn
Bozin, M
Thomson, BN
Mann, GB
Tan, SBM
Clark, DA
Daruwalla, J
Muralidharan, V
Najan, N
Pitcher, ME
Vilhelm, K
Cox, MR
Lane, Stephen
Watters, David
Journal name ANZ journal of surgery
Volume number 87
Start page 1
End page 5
Total pages 5
Publisher Wiley
Place of publication Milton, Qld.
Publication date 2016-09-06
ISSN 1445-1433
Keyword(s) appendicitis
laparoscopic appendicectomy
open appendicectomy
Science & Technology
Life Sciences & Biomedicine
Summary BACKGROUND: Recent data suggest that laparoscopic appendicectomy (LA) in pregnancy is associated with higher rates of foetal loss when compared to open appendicectomy (OA). However, the influence of gestational age and maternal age, both recognized risk factors for foetal loss, was not assessed. METHOD: This was a multicentre retrospective review of all pregnant patients who underwent appendicectomy for suspected appendicitis from 2000 to 2012 across seven hospitals in Australia. Perioperative data and foetal outcome were evaluated. RESULTS: Data on 218 patients from the seven hospitals were included in the analysis. A total of 125 underwent LA and 93 OA. There were seven (5.6%) foetal losses in the LA group, six of which occurred in the first trimester, and none in the OA group. After matching using propensity scores, the estimated risk difference was 5.1% (95% confidence interval (CI): 1.4%, 9.8%). First trimester patients were more likely to undergo LA (84%), while those in the third were more likely to undergo OA (85%). Preterm delivery rates (6.8% LA versus 8.6% OA; CI: -12.6%, 5.3%) and hospital length of stay (3.7 days LA versus 4.5 days OA; CI: -1.3, 0.2 days) were similar. CONCLUSION: This is the largest published dataset investigating the outcome after LA versus OA while adjusting for gestational and maternal age. OA appears to be a safer approach for pregnant patients with suspected appendicitis.
Language eng
DOI 10.1111/ans.13750
Field of Research 1103 Clinical Sciences
Socio Economic Objective 920507 Women's Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Royal Australasian College of Surgeons
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Document type: Journal Article
Collection: School of Medicine
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